Team-Based Primary Care Reduced Hospitalizations, Medicare Spending
Issue Number
748
January 26, 2021
AHRQ Stats
Access more data on this topic in the associated statistical brief.
Today's Headlines:
- Team-Based Primary Care Reduced Hospitalizations, Medicare Spending.
- Applications Due March 24 for Grants Aimed at Implementing Nonsurgical Treatments for Urinary Incontinence.
- AHRQ Grantee Profile Highlights Work of Justin Dimick, M.D., M.P.H., To Improve Outcomes for Patients by Optimizing Surgical Performance.
- Highlights From AHRQ’s Patient Safety Network.
- Increase in Calculated Perforated Appendicitis Rates Among Pediatric Patients May Be Due to Improved Diagnostic Accuracy.
- New Research and Evidence From AHRQ.
- AHRQ in the Professional Literature.
Team-Based Primary Care Reduced Hospitalizations, Medicare Spending
Primary care practices that included nurse practitioners and/or physician assistants in the care process saw reduced hospitalizations and Medicare costs when compared with practices centered around a physician, according to an AHRQ-funded study published in The Journal of the American Geriatrics Society. Team-based practices showed a higher degree of collaborative care and less centralized decision-making practices, according to researchers who developed a map showing pathways of communication among staff at each practice. Of the nearly 450,000 patients reviewed, those at practices with greater collaborative care were 0.89 times as likely to be hospitalized, and Medicare spending was 0.86 times what it would be at a practice with less collaborative care. Access the abstract.
Applications Due March 24 for Grants Aimed at Implementing Nonsurgical Treatments for Urinary Incontinence
Grant applications are due March 24 for projects aimed at disseminating and implementing patient-centered outcomes research findings in primary care practices to improve nonsurgical treatments for urinary incontinence among women. Nearly 20 percent of women in the United States report moderate to severe urinary incontinence, but few receive treatment. AHRQ anticipates investing up to $15 million over three years to support up to five awards. The initiative grew from a previous AHRQ report, Nonsurgical Treatments for Urinary Incontinence in Women: A Systematic Review Update. A technical assistance call on Feb. 25, from 3 to 4 p.m. ET, will provide a summary of the initiative and address frequently asked questions. Access the funding opportunity announcement or email UI_grant@ahrq.hhs.gov for more information, including how to register for the technical assistance call and how to submit a letter of intent.
AHRQ Grantee Profile Highlights Work of Justin Dimick, M.D., M.P.H., To Improve Outcomes for Patients by Optimizing Surgical Performance
Check out AHRQ’s latest grantee profile featuring the work of Justin Dimick, M.D., M.P.H., chair of the University of Michigan’s Department of Surgery in Ann Arbor. Dr. Dimick has focused on improving outcomes for patients by developing new methods, including use of video analysis, to help surgeons better measure and optimize their individual performance. Access more about Dr. Dimick’s work as well as additional AHRQ profiles.
Highlights From AHRQ’s Patient Safety Network
AHRQ’s Patient Safety Network (PSNet) highlights journal articles, books and tools related to patient safety. Articles featured this week include:
- Association of unexpected newborn deaths with changes in obstetric and neonatal process of care.
- Nurse burnout predicts self-reported medication administration errors in acute care hospitals.
- Wrong-site surgery in Pennsylvania during 2015–2019: a study of variables associated with 368 events from 178 facilities.
- A roadmap to advance patient safety in ambulatory care.
Review additional new publications in PSNet’s current issue or access recent cases and commentaries in AHRQ’s WebM&M (Morbidity and Mortality Rounds on the Web).
Increase in Calculated Perforated Appendicitis Rates Among Pediatric Patients May Be Due to Improved Diagnostic Accuracy
A rise in the proportion of perforated appendicitis cases seen among 1- to 17-year-olds diagnosed with acute appendicitis may actually reflect more accurate exclusion of non-appendicitis cases, according to a study published in JAMA Network Open by AHRQ intramural researchers. According to data from the internal Disparities Analytic File of AHRQ’s Healthcare Cost and Utilization Project (HCUP), the rate of perforations rose from just over 317 per 1,000 appendicitis cases in 2001 to nearly 458 per 1,000 cases in 2015. However, national estimates based on the HCUP National Inpatient Sample and HCUP Kids’ Inpatient Database both showed decreases in the overall number of appendicitis cases within that same timeframe. As the number of perforation cases remained relatively steady, the decrease in overall appendicitis cases was driven by a decrease in nonperforated cases. Providers may be more accurately excluding patients who were previously misdiagnosed with nonperforated appendicitis from the total number of appendicitis cases recorded. This exclusion reduces the overall denominator used to calculate appendicitis rates, thereby inflating the percentage of appendicitis cases listed as perforations. Access the abstract.
New Research and Evidence From AHRQ
AHRQ in the Professional Literature
Benchmarking treatment effectiveness of community-delivered trauma-focused cognitive behavioral therapy. Rudd BN, Last BS, Gregor C, et al. Am J Community Psychol 2019 Dec;64(3-4):438-50. Epub 2019 Aug 20. Access the abstract on PubMed®.
A comparison of estimated cost savings from potential reductions in hospital-acquired conditions to levied penalties under the CMS Hospital-Acquired Condition Reduction Program. Sankaran R, Gulseren B, Nuliyalu U, et al. Jt Comm J Qual Patient Saf 2020 Aug;46(8):438-47. Epub 2020 May 11. Access the abstract on PubMed®.
Group B streptococcal bacteriuria in pregnancy: an evidence-based, patient-centered approach to care. Schafer R, Phillippi JC. J Midwifery Womens Health 2020 May;65(3):376-81. Epub 2020 Feb 25. Access the abstract on PubMed®.
Processes and outcomes of diabetes mellitus care by different types of team primary care models. Guo F, Lin YL, Raji M, et al. PLoS One 2020 Nov 5;15(11):e0241516. Access the abstract on PubMed®.
Implementation of community-based resource referrals for cardiovascular disease self-management. Abramsohn E, DePumpo M, Boyd K, et al. Ann Fam Med 2020 Nov;18(6):486-95. Access the abstract on PubMed®.
Statewide asthma learning collaborative participation and asthma-related emergency department use. Harder VS, Shaw JS, McCulloch CE, et al. Pediatrics 2020 Dec;146(6):e20200213. Access the abstract on PubMed®.
Care integration within and outside health system boundaries. Singer SJ, Sinaiko AD, Tietschert MV, et al. Health Serv Res 2020 Dec;55(Suppl 3):1033-48. Access the abstract on PubMed®.
Perinatal depression in low-income women: a literature review and innovative screening approach. Klawetter S, McNitt C, Hoffman JA, et al. Curr Psychiatry Rep 2020 Jan 7;22(1):1. Access the abstract on PubMed®.
